2002-935 TOWN QF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20020935 Date Issued: Monday, January 06,2003
This is to certify that work requested to be done as shown by Permit Number P20020935
has been completed.
Tax Map Number: 523400.296-013-0001-069-000-0000
Location: 966 STATE ROUTE 9
Owner: V.S.H.REALTY INC.
Applicant: CUMERLAND FANS
This structure may be occupied as a:
By Order of Town Board
Commercial Alteration TOWN OF QUEENSBURY
Installation of Tank
Director of Building&Code Enforcement
TOWN OF QUEENSBUkY,
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020935 Application Number; A2002005
Tax Map No: 523400-296-013-0001-069-000-0000
Permission is hereby granted to: ANDREW BOMBARD
For property located at: 966 STATE ROUTE 9
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other informationil hereto filed
and approved and in compliance with the NYS Unif6rin Building Codes and the Queensbury Zoning
Ordinance. Ti
e of Construction Value
f
Owner Address: V.S.H. REALTY INC. I
-777 DEDHAM St Commercial Alteration
Installation of Tank
CANTON, MA. 02021 Total Value
Contractor or Builder's Name Address Electrical Inspection�Agency
ANDREW BOMBARD
81 NEW Rd
EAST C-YREF.NBIJSfT-NY
1
Plans&Specifications I
2002-935
Construction of a 2,208 sq ft canopy and installation of gas.tanks per regulations,plot Plana an
specifications.
�$100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,Novembk oo-5;-2003-
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Queenqbllry)- F id y,November 15,2002. j I
SIGNED BY for the Town of Queensbury.
Director of Building '�h Code forcement
Building Permit .Application
Town of Queensbury—.Dept of Community Development,742 Bay Road, Queensbury,NY ?
(5i8)761-8256
I
�p2i
A permit must be obtained before beginning'construction. Permit File No. _t 1 l,� �1�
No inspection will be made until-applicant has received a Fee Paid $ 100 ( l� t
valid building permit. All applicants' spaces on.this Rec.Fee Paid $
application must be completed and must appear on.the Reviewed By:
application form. " 1 E E� V E D
Applicant: vf�Zl�.• >' C� Owner: ,a / i
Address: Address. �,-2 s I NOV 0 .7 2002
Phone#( � .5�3- Phone# — )C 33WT0WN OF QUEENSBURY
Email Address:&t 2Ub .csf / a> ef'� Email Address: 1 BUILDING AND CODE
i
Property Location: Lot Number: / I-Iou'se Number " 1
Subdivision Name: Tax Map Number Clq
❑ New Building: residence/commercial Estimated Market Value of Construction: $ GHQ
❑ Addition: residence/ commercial
❑ Alteration residence/ commercial If an Addition,what will use of new addition be?
❑ No change to exterior size: residence/com'l
❑ Other work(describe &4ortf-'44 }
Check OccupancyInformation I"Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
❑ Single family dwelling j
❑ Two family dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units '
❑ Office
❑ Mercantile
❑ Manufacturin ;
0 1 car detached garage E
❑ 2 car detached garage
❑ 3 car detached garage`. �.
❑ 1 car attached garage +
❑ 2 car attached garage
❑ 3 car attached garage
❑ Storage building-
commercial
❑ Storage building-
residential
❑ Other tG /° �'f c j X 2__1 c�'S
What is the proposed height of the structure " feet inches
Will any second-hand or ungraded lumber be used? If so,for what?
{
Type of Heating System: electric/ oil ! gas/wood /forced hot air t baseboard I other:
Number of Fireplaces to be installed. Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder .
Plumber
Mason,
Electrician
Declaration: please sign below after you have carefully read the statement: {
I
To the best of my knowledge the statements'contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether specified or noted,and that-such work is authorized by the owner. Further,it is,understood that Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of CompliancQ being issued,as requested by the Zoning
Administrator or Dir c or of Buildi 9 and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all ne c �ti2n__�-*'
j
Signaturae � owner, wne-r'ss—a-g-e-n,architect,contractor j
COBU4ERCIAL FINAL INSPECTION REPORT
Building& Code Enforcement Date inspection request received:
Office No. (518)761-8256
Dept. of Community(Development y
Town of Qiaeensbury Arrive )0 am/ptn Depart pm
742 Bay Road Inspector's Initials 1
Queensbury,NY 12804
NAME CJ M��� �.�J f���_ PERMIT
LOCATION DATE o 5 1
TYPE OF STRUCTURE
N/A YES NO COMMENTS
ChiameyP'B"VentlDirect Vern location
Plumbing Vent
Roof Complete
Exterior finish grade complete
latenior/ex erior guardrails 42 in.platform/decks
hazior/exeriorballastess 4 in.spacingplatform/decks
Stair handrail 34 in.-38 in.
Step risers 7%in.
Maim door 44 in.
All others 36 in.
Lever handles
Exits at grade or platform
Candy to cover req.exit doors
Gas valve shut-off exposed®ulator(18 in.)above gra
Floor bathroom watertight
Other floors okay
Hat water relief valve
Boiler/firrmce enclosure
<250,000 BTU N/R
250.000 BTU to 1,000.000 BTU's(I hour)
>1,000,000 BTU's(2 hour)
Gas furnace shut off within 301 or within line of site
Oil furnace shut off at entrance to furnace area
Stockroom enclosure(1 hour),3/4 hour door
Storage/receivinglshipping room(2 hour),I '/z doors
1 1,i hour doors and closers
3 4 hour corridor doors and closers
Firewalls/fire separation,2 hour,3 hour complete
Fire dampers,2 hour fire wall/separation or greater
Fire door/shutters I '/a hour,3 hour
Ceiling fire stopping 3,00015,000 sq.ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
Elevators
Elevator signage
Handicapped bathroom grab bars/sinWoilets
Handicapped bath/parking lot signage
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space
Final EIectrical
Site PlanNariance required_
Final Survey,new structures
As-buih septic system layout required
Okay to issue temp.C/O(Certif.of Occupancy)
Okay to issue permanent C/O(Certif.of Occupancy)
Okay to issue C/C(Certif.of Compliance)
CON&MRCIAL FINAL INSPECTION REPORT AIM
Building& Code Enforcement Date inspection.request received;
Office No.(518)761-8256
Dept~ of Community Development �
Town of Qneensbury Arrive + W am/pm Depart am/pm
742 Bay Road Inspector's initials
Queensbury,NY 12804
NAME PERMIT#9-0
RATIO DATE - - �L� n
TYPE OF STRU
N/A ICES NO COAriIviENTS
ChimneyPIT'Vent/Dired Vent location
Plumbing Varrt
Roof Complete
Exterior finish grade Mete
Inurior/exterior guardrails 42 in.platform/decks
Interior/exterior ballasters 4 in.spacing platform/decks
Stair handrail 34 in.-38 in.
Step risers 7 3/4 m.
Main door 44 in.
All others 36 in.
Lever handles
Exits at grade or platform
Canopy to cover req.exit doors
Gas valve shut-off exposed®ulator(18 in.)above gra
Floor bathroom watertight
Other floors okay
Hat water relief valve
Boiler/f mace enclosure
<250,000 BTU N/R
250,000 BTU to 1,000,000 BTU's(I hour)
>1,000,000 BTU's(2 hour)
Gas furnace shut off within 301 or within line of site
Oil furnace shut off at entrance to f imace area
Stockroom enclosure(1 hour),3/4 hour door
Storage/receiving/shipping room(2 hour), I '/z doors
I '/Z hour doors and closers
}4 hour corridor doors and closers
Firewalls/fire separation,2 hour,3 hour complete
Fire dampers,2 hour fire wall/separation or greater
Fire door/shutters 1 '/z hour,3 hour
Ceiling fire stopping 3,000/5,000 sq.ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
Elevators
Elevator signage
Handicapped bathroom grab bars/sinks/toilets
Handicapped bath/parking lot signage
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
.Active listening system and signage assembly space
Final Electrical
Site Plan/Variance required_ I
Final Survey,new structures
As-buih septic system layout required
Okay to issue temp.C/O(Certif of Occupancy)
Okay to issue permanent C/O(Certif.of Occupancy)
Okay to issue C/C(Certif.of Compliance)
Town of Queensbury
Fire Marshal's Office
742 Bay Road I 3�K
Queensbury, NY 12804
Phone (518)761-8205 Fax(518) 745-443
Fire Marshal's Inspection Report
Request SCHEDULE
Received: Permit#- INSPECTION ON:
Name: OVO _AM M ANYTIME
Location. I" " lift
APPROVED
N/A YES NO COMMENTS
EXITS
AISLE WIDTHS
EXIT SIGNS-NORMAL W61M
- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE
COMPRESSED GAS
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN
CHIMNEY
MASONRY ROUGHIN
FINAL
CHIMNEY Cqo, 41
FACTORY BUILT ROUGH IN
FINAL
WOOD .
STOVE ROUGH IN
FINAL
VENTED GAS
APPLIANCE ROUGH IN
FINAL
FIREPLACE
MASONRY ROUGH IN OK THIS DATE OK FOR CO NOT OK
FINAL
FIREPLACE
FACTORY BUILT ROUGH IN s"ev
NSPECTED BY
FINAL
COMDEV/CHPJSJNVORDILETTERS20DI/FIREMARSHALINSPECTIONREPORT11022601
WHITE-BUILDING DEPARTMENT COPY YELLOW OCCUPANT COPY
E
office Use
.GENERAL INSPECTION REPORT Inspector:
Ready at titre.:"..'
Town of Queensbury I
Dept. of Community Development Request received. Meet:
Building& Code Enforcement At time:j�
742.Bay Road I
Queensbury, NY 12804 ARRIVE\jLt jCdrPERMrr
R am/. rotes:
(518) '761-8256 .Inspector's InitialNAME: # 206Z,- t -31T
q
LOCATION: - ! INSPECT ON(date): ) 2- �1A Z �r;
TYPE OF.STRUCTURE: �6Y►�wt . ��-�- t/������-�----- ,
RECHECK.
N/A I YES440 COMMENTS
�otingslPiexs
onolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
'Foundation/W allp our_
Reinforcement in Place
Foundation/D amppro offing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R
Floors R- _
Walls R-
ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
BracingBridgmg
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4.hour
Firestopping
L:\.SueHemiisgway\Building.Codes.Inspection.FORMSIGENERAL INSPECTION REPORTAce
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